IS A BIOPSY NECESSARY TO MAKE THE DIAGNOSIS OF ALOPECIA AREATA?
Skin biopsies under appropriate circumstances may provide a wealth of information. It is necessary when diagnosing tumors, vasculitides, etc. However, these conditions pose a different scenario to alopecia areata where the diagnosis is based on clinical grounds. I would entertain performing a biopsy in a patient if the clinical symptoms are not characteristic, for e.g., if hair loss occurs in a reticular or diffuse pattern. I would also consider a biopsy if faced with a therapeutical decision. If the biopsy shows a lot of inflammation, steroids are indicated. On the other hand, if the biopsy shows scar tissue then there is no indication for the use of steroids. Otherwise, biopsies are used primarily for research protocols and pharmaceutical trials. If the doctor does the biopsy to rule out lupus, I would change doctors. This is not a valid reason to perform a biopsy. If your doctor decides on obtaining a biopsy for valid reasons then both the timing and the site may be all important. T
